Retentive strength of fiber-reinforced composite posts with composite resin cores: Effect of remaining coronal structure and root canal dentin conditioning protocols.

Statement Of Problem: The prognosis of a fixed dental prosthesis cemented to endodontically treated teeth is primarily determined by the presence of a ferrule on the tooth. Adhesion of the post in the root canal, conditioning methods for the canal and the amount of coronal structure could also be decisive on survival of reconstructions cemented on endodontically treated teeth.

Purpose: The purpose of this in vitro study was to test the effect of remaining coronal structure on the retention of airborne-particle abraded fiber-reinforced composite resin posts built up with composite resin cores after the treatment of root canal dentin with different conditioning protocols.

Material And Methods: One hundred and fifty extracted human teeth with single root canal space were endodontically treated and divided into 3 groups as follows: group CEJ: the teeth were sectioned at the level of cementoenamel junction (CEJ); group CEJ1: the teeth were sectioned 1 mm above the CEJ; group CEJ2: the teeth were sectioned 2 mm above the CEJ. Each group was further divided into 5 subgroups (n=10 per group) according to the root canal treatments as follows: group C: no conditioning (control); group PH: conditioning with 37% phosphoric acid gel for 15 seconds; group E: conditioning with 17% ethylenediaminetetraacetic acid (EDTA) for 60 seconds; group CHX: conditioning with 2% chlorhexidine (CHX) for 60 seconds; group Q: conditioning with combination of 2% CHX with 17% EDTA and a surfactant solution for 60 seconds. Glass fiber-reinforced composite resin posts were airborne-particle abraded and luted to the root canal dentin with a self-adhesive resin cement (RelyX Unicem). The retentive force was tested by applying a tensile load parallel to the long axis of these posts at a crosshead speed of 2 mm/min. Two-way ANOVA and the Tukey HSD post hoc test were used to analyze the data.

Results: The highest retention (N) was obtained with the CHX-EDTA conditioned group (374.7 ±29.8) followed by 17% EDTA (367.9 ±33.3) conditioning when 2 mm remaining coronal structure was available. Conditioning with the CHX-EDTA showed comparable retention values to 17% EDTA conditioned groups when 0 or 1 mm coronal structure was present that differed significantly compared to 37% PH and 2% CHX conditioning (P<.05).

Conclusions: Conditioning root canal either with CHX-EDTA or 17% EDTA delivered superior retention values for fiber-reinforced composite resin posts with composite resin cores that were luted with self-adhesive resin cement to endodontically treated teeth with 2 mm remaining coronal structure.